THE WHITE HOUSE
Office of the Press Secretary
(
_______________________________________________________________
For
Immediate Release
EXECUTIVE ORDER
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PROMOTING QUALITY AND EFFICIENT
HEALTH CARE
IN FEDERAL GOVERNMENT
ADMINISTERED OR SPONSORED
HEALTH CARE PROGRAMS
By
the authority vested in me as President by the Constitution and the laws of the
Section 1. Purpose. It is the purpose of
this order to ensure that health care programs administered or sponsored by the
Federal Government promote quality and efficient delivery of health care
through the use of health information technology, transparency regarding health
care quality and price, and better incentives for program beneficiaries,
enrollees, and providers. It is the further purpose of this order to make
relevant information available to these beneficiaries, enrollees, and providers
in a readily useable manner and in collaboration with similar initiatives in
the private sector and non-Federal public sector. Consistent with the purpose
of improving the quality and efficiency of health care, the actions and steps
taken by Federal Government agencies should not incur additional costs for the
Federal Government.
Sec.
2. Definitions. For purposes of this order:
(a)
"Agency" means an agency of the Federal Government that administers
or sponsors a Federal health care program.
(b)
"Federal health care program" means the Federal Employees Health
Benefit Program, the Medicare program, programs operated directly by the Indian
Health Service, the TRICARE program for the Department of Defense and other
uniformed services, and the health care program operated by the Department of
Veterans Affairs. For purposes of this order, "Federal health care
program" does not include State operated or funded federally subsidized programs
such as Medicaid, the State Children's Health Insurance Program, or services
provided to Department of Veterans' Affairs beneficiaries under 38 U.S.C. 1703.
(c)
"Interoperability" means the ability to communicate and exchange data
accurately, effectively, securely, and consistently with different information
technology systems, software applications, and networks in various settings,
and exchange data such that clinical or operational purpose and meaning of the
data are preserved and unaltered.
(d)
"Recognized interoperability standards" means interoperability
standards recognized by the Secretary of Health and Human Services (the
"Secretary"), in accordance with guidance developed by the Secretary,
as existing on the date of the implementation, acquisition, or upgrade of
health information technology systems under subsections (1) or (2) of section
3(a) of this order.
Sec.
3. Directives for Agencies. Agencies shall perform the
following functions:
(a)
Health Information Technology.
(1)
For Federal Agencies. As each agency implements, acquires, or upgrades health
information technology systems used for the direct exchange of health
information between agencies and with non-Federal entities, it shall utilize,
where available, health information technology systems and products that meet
recognized interoperability standards.
(2)
For Contracting Purposes. Each agency shall require in contracts or agreements
with health care providers, health plans, or health insurance issuers that as
each provider, plan, or issuer implements, acquires, or upgrades health
information technology systems, it shall utilize, where available, health
information technology systems and products that meet recognized
interoperability standards.
(b)
Transparency of Quality Measurements.
(1)
In General. Each agency shall implement programs measuring the quality of
services supplied by health care providers to the beneficiaries or enrollees of
a Federal health care program. Such programs shall be based upon standards
established by multi-stakeholder entities identified by the Secretary or by
another agency subject to this order. Each agency shall develop its quality
measurements in collaboration with similar initiatives in the private and
non-Federal public sectors.
(2)
Facilitation. An agency satisfies the requirements of this subsection if it
participates in the aggregation of claims and other appropriate data for the
purposes of quality measurement. Such aggregation shall be based upon standards
established by multi-stakeholder entities identified by the Secretary or by
another agency subject to this order.
(c)
Transparency of Pricing Information. Each agency shall make available (or
provide for the availability) to the beneficiaries or enrollees of a Federal
health care program (and, at the option of the agency, to the public) the
prices that it, its health insurance issuers, or its health insurance plans pay
for procedures to providers in the health care program with which the agency,
issuer, or plan contracts. Each agency shall also, in collaboration with
multi-stakeholder groups such as those described in subsection (b)(1),
participate in the development of information regarding the overall costs of
services for common episodes of care and the treatment of common chronic
diseases.
(d)
Promoting Quality and Efficiency of Care. Each agency shall develop and
identify, for beneficiaries, enrollees, and providers, approaches that
encourage and facilitate the provision and receipt of high-quality and efficient
health care. Such approaches may include pay-for-performance models of
reimbursement consistent with current law. An agency will satisfy the
requirements of this subsection if it makes available to beneficiaries or
enrollees consumer-directed health care insurance products.
Sec.
4. Implementation Date. Agencies shall comply with the
requirements of this order by
Sec.
5. Administration and Judicial Review.
(a)
This order does not assume or rely upon additional Federal resources or spending
to promote quality and efficient health care. Further, the actions directed by
this order shall be carried out subject to the availability of appropriations
and to the maximum extent permitted by law.
(b)
This order shall be implemented in new contracts or new contract cycles as they
may be renewed from time to time. Renegotiation outside of the normal contract
cycle processes should be avoided.
(c)
This order is not intended to, and does not, create any right or benefit,
substantive or procedural, enforceable at law or in equity against the United
States, its departments, agencies, or entities, its officers, employees, or
agents, or any other person.
GEORGE W.
BUSH
THE
WHITE HOUSE,
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